The dreaded norovirus – so easy to hand off

The alarm went off at 7 a.m. the morning my wife and I were leaving for Hawaii some years ago – but I was already awake. I had been hit early in the evening with severe nausea and stomach cramps.

The ride to the airport was pretty rough, but the eight-hour flight to the island paradise was near misery. I spent most of my time at cruising altitude out of my seat and, shall we say, indisposed.

Pretty soon, I knew that I had been struck by the dreaded norovirus. In retrospect, I recalled a similar illness among co-workers the previous week.

Noroviruses are actually a whole family of viruses, which collectively are responsible for more than 20 million cases of gastroenteritis in the United States each year.

Gastroenteritis is a viral infection of the stomach and intestines. The main symptoms include nausea, vomiting, stomach cramps and frequent watery diarrhea.

Norovirus is extremely infectious. It is passed along in fecal matter (yes, that means poop), typically on the hands of infected persons or on the inanimate objects they touch (think doorknobs, phones and countertops), where it can survive for many hours. Once the virus reaches the hand of a new victim, it takes only a little itch to bring it to the mouth, and then there’s no going back. Nearly everyone who becomes infected gets sick – unlike other viruses.

For most otherwise healthy people, norovirus is only an inconvenience. Its symptoms typically last only a couple of days and resolve as quickly as they start. It does contribute to lost workdays and, as in my case, has ruined many a vacation. Cruise ship outbreaks are the stuff of legend.

However, for infants, the elderly and those with chronic illness, norovirus can lead to dangerous levels of dehydration. Norovirus accounts for 70,000 hospitalizations and 800 deaths each year in the United States.

Previous infection does not confer much protective immunity because norovirus constantly mutates into new forms.

Perhaps you have heard reports of a new norovirus strain from Australia, which is circulating this season. It seems especially potent and difficult to kill. Because it’s new, most people do not have immunity.

Infected people should avoid food preparation for at least three days and up to two weeks after resolution of symptoms. In all cases, food preparation surfaces should be thoroughly cleansed with a bleach-based household cleaner before and after meals. Utensils should not be shared. Potentially infected laundry should be thoroughly washed in hot water.

The best protection against norovirus infection is good hand hygiene. This new strain seems not to be stopped by hand sanitizer. Good old-fashioned hand washing with soap and water is the key. I’m talking lathering up your hands for 30 seconds, washing all surfaces (including under nails) and using a hot-water rinse.

My infection was mercifully short. The symptoms resolved by the time I got to the hotel – just in time for me and my wife to head out to the beach. Unfortunately, a couple of days later on the way back from snorkeling it hit my wife. Whoops ... sorry, Sweetie.

Dr. Matthew A. Clark is a board-certified physician in internal medicine and pediatrics practicing at the Ute Mountain Ute Health Center in Towaoc.